Fever is your friend And not your enemy
When I proclaimed this statement for Arushi, a 12 year old girl, presented with the complaint of high grade temperature since morning, her parents were confused and their facial expression mirrored their feelings that they have probably visited the wrong doctor. I paused for a moment and requested them to calm down and hear me out for the next few minutes.
What is fever? Friends, fever is our immunity’s response to a “toxic agent” which enters into our body to invade and destroy our tissues and life. Most of the times, this “Toxic agent” is either virus, bacteria or other microorganism which we collectively call “Pathogens”. (Sometimes fever is also caused due to non infectious causes which we will discuss some other day).
Once these pathogenic microorganisms enter, our body’s vigilance system immediately recognizes them & reports to the immunity system. Various cells of the vigilance and immunity system start firing multiple “signals” to our brain, blood and bone marrow -where our army is residing- so that our fighter cells like Macrophages, white blood cells, Lymphocytes, etc. can be rushed to the battle field & kill the terror causing virus or bacteria or other pathogens.
Benefits of Fever- Now, through one of the widely accepted theories, it is established that the elevation of body’s temperature achieves dual benefits 1) In elevated temperature, most of the microorganisms find it difficult to survive and they start dying or slow down their growth & proliferation. 2) Our immune system works faster& swifter at higher temperatures.
For elevating body temperature, “Pathogen detector cells” send certain signals to the brain’s “temperature control centre” and higher set-point of the new temperature is set. Now in order to reach this higher goal, our body constricts the blood vessels which prevent heat loss and causes contraction of muscles, felt as shivering, resulting into the generation of heat. Many reptiles or amphibians staying in a cold water do not have these mechanism of increasing body temperature hence, when they get infected, they travel to hot springs or hotter area so that their body’s temperature is increased and germs are killed.
Once this process is understood and if we are convinced then it becomes very clear that “Fever is our friend and not a Foe” Higher temperature (up to certain limit or threshold) helps us fight toxic pathogensin better way. And when we administer “fever lowering” medications (called as Antipyretics) like Paracetamol, Brufen, Mefenemic acid or Nimusulide , these antipyretics just lower the higher set point to a lower one which brings down body’s temperature but at the same time they help toxic virus or bacteria grow faster and attune our immune system. This consequently leads to survival of pathogens & lengthening of the duration of infection in the body. Stronger the antipyretics worse are the outcome. Plus they also mask the pattern of the fever and diagnosis becomes difficult.
Listening to this, somewhat in a tenor of acceptance, Mrs. Jain asked, does it mean we should never lower the temperature? But we can’t see our child in pain and discomfort, and what if the fever “goes” into the brain?
In reply, I asked them a counter question, what they will do if they smell something stink in their house. Will they just mask it by spraying a room freshener or will they try to find the source of foul smell and throw it out? We will do both the things, was the smart answer by the Jains!!I was happy to see an easing expression on their faces.
Approach to treat Fever- I said similarly in case of fever, first, we must find out a “location”of the microorganism hidden in which system or tissue and thereafter, based on the signs and symptoms and based on our experience, we try to understand which kind of “Pathogen” is causing the fever and decide the treatment accordingly. Just giving an antipyretic is like spraying the room freshener. Albeit, it is very essential to make your child comfortable, we do give antipyretics, but in the initial phase when load of Pathogen and signaling is more in the body, the fever does not come down immediately and at this point one must remember that giving stronger medications like Brufen or Meftal or Nimusulide can be hazardous. Many a times the fever could be due to dengue or chikungunya. In such cases, Brufen etc. will further reduce / damage the Platelet count. Thus the aim of giving antipyretic is ‘not to reduce’ the fever but to control it from rising further to a higher level like 104 or 105 degree Fahrenheit and to reduce the body pain and other discomfort. For this, till date, Paracetamol is found to be a safer and a preferred antipyretic over others. Further if the child is very weak or has a history of convulsions or any other serious respiratory or cardiac ailments then we must try to lower temperature in a best possible way. Other than such exceptional cases, in all other healthy children, generally fever does not do them any harm. Most of the times, fevers in children are of Viral origin and most of them start with very high degree like 102-103-104 degree Fahrenheit but by day three or four the fever settles down. So they do not need antibiotics. As such antibiotics are of no use in Viral fever as antibiotics act only on bacteria.
Further, if you give Paracetamol in a correct dose, fever comes down to normal and it comes back after 4 to 6 hours but in between these two spikes the child is well, not dull, little irritable but otherwise “does not look toxic” . This response to Paracetamol & a non-toxic appearance in between the spikes are a very very important diagnostic signs. And by and large, these two signs rule out bacterial infection. In Bacterial infections, generally, the fever is moderate in the initial days but after three days it increases and the response to Paracetamol becomes poor, it does not come down to normal level of 98.5 degree plus child is also “sick” in between the two spikes. Now if we give strong medications to lower the temperature, we miss all these vital information and it becomes difficult to locate the whereabouts of pathogens in our body. Once the pathogen and the affected system is understood, we prescribe antibiotics accordingly. And can prevent patient from taking unnecessary higher antibiotics. (In Malaria too child may look healthy in between the two spikes of fever, but IN malaria Temperature is erratic may come at any interval of time, which is not so in Viral fever).
Herbal Medicines for Fever- Certain herbal medications like Tinospora, Mahasudarshan or Sitopaladi, Kantakari, Tulsi etc. are value added medicines which improve the patients’ immunity and fight back the infection well. Papaya leaf juice and Hemidismus indicus and Pomegranate extract are excellent for cooling down & for preventing the destruction of Platelets in Dengue, Malaria and chikungunya. All these herbs stimulate the Liver to produce more antibodies.
Throughout the course of fever one must give herbal medicated water of Sandlewood, Musta, Parpat, Usheer. All these herbs reduce excess of heat and keep body well hydrated.
Diet during Fever- As per Ayurveda, the diet should be easy to digest and light & also to be nourishing and detoxifying. The best recipe would be of 1 part of green gram + 2 parts of rice roasted together for 5 to 7 minutes and then boiled in water and simmered with homemade ghee and jeera, mustard seeds, hing, cloves, Black pepper, ginger and salt. Plus vegetable soup. But strictly, maida and bakery products should be avoided as they interfere with the production of some proteins which are required to kill pathogens. Remember that, regaining of hunger is most important indication of waning of toxins from the body. Patient should take full rest & all measures to prevent spread to others to be taken.
Last but not the least, As Arushi was suffering from Viral fever and as I already predicted to her parents, her fever was totally cured by day four , without the need of giving any antibiotics or any strong Antipyretics. Parents were very happy and thanked for guiding and removing the “Fear of Fever”.
Note: Always consult your family physician and avoid self medication
(Senior Ayurveda Consultant)